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Exploring the Changes in Code Status During the COVID-19 Pandemic and the Implications for Future Pandemic Care.
Katamreddy, Adarsh; Ye, Alexander M; Vorchheimer, David A; Hardoon, Isaac; Faillace, Robert T; Taub, Cynthia C.
  • Katamreddy A; Department of Medicine, 24502Albert Einstein College of Medicine/Jacobi Medicine Center, Bronx, NY, USA.
  • Ye AM; 318805Greenwich High School, Greenwich, NY, USA.
  • Vorchheimer DA; Division of Cardiovascular Disease, Department of Medicine, 384397Albert Einstein College of Medicine/Montefiore Medicine Center, Bronx, NY, USA.
  • Hardoon I; Palliative Care, Department of Family and Social Medicine, 12285Albert Einstein College of Medicine/ Montefiore Medicine Center, Bronx, NY, USA.
  • Faillace RT; Department of Medicine, 24502Albert Einstein College of Medicine/Jacobi Medicine Center, Bronx, NY, USA.
  • Taub CC; Division of Cardiovascular Disease, Department of Medicine, 384397Albert Einstein College of Medicine/Montefiore Medicine Center, Bronx, NY, USA.
Am J Hosp Palliat Care ; 39(11): 1364-1370, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-1808087
ABSTRACT

Objective:

We aim to explore patterns of inpatient code status during the COVID-19 pandemic compared with a similar timeframe the previous year, as well as utilization of palliative care services.

Methods:

This is a retrospective cohort study using data from the Montefiore Health system of all inpatient admissions between March 15-May 31, 2019 and March 15-May 31, 2020. Univariate logistic regression was performed with full code status as the outcome. All statistically significant variables were included in the multivariable logistic regression.

Results:

The total number of admissions declined during the pandemic (16844 vs 11637). A lower proportion of patients had full code status during the pandemic (85.1% vs 94%, P < .001) at the time of discharge/death. There was a 20% relative increase in the number of palliative care consultations during the pandemic (12.2% vs 10.5%, P < .001). Intubated patients were less often full code (66.5% vs 82.2%, P < .001) during the pandemic. Although a lower portion of COVID-19 positive patients had a full code status compared with non-COVID patients (77.6% vs 92.4%, P<.001), there was no statistically significant difference in code status at death (38.3% vs 38.3%, P = .96).

Conclusions:

The proportion of full code patients was significantly lower during the pandemic. Age and COVID status were the key determinants of code status during the pandemic. There was a higher demand for palliative care services during the pandemic.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Hospice and Palliative Care Nursing / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Limits: Humans Language: English Journal: Am J Hosp Palliat Care Journal subject: Nursing Year: 2022 Document Type: Article Affiliation country: 10499091221092699

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Hospice and Palliative Care Nursing / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Limits: Humans Language: English Journal: Am J Hosp Palliat Care Journal subject: Nursing Year: 2022 Document Type: Article Affiliation country: 10499091221092699